Question re cholesterol

[Sam50]

Morning All,

Hope you don't mind me asking what is probably a very obvious question.

Went with Hubby to see the nurse yesterday as he had more blood test results to collect. Kidney function- all normal, thyroid function-all normal and cholesterol-slightly elevated. Which was no great surprise as he is a new T2 and the blood test had been a non fasting one.

His total cholesterol was 5.2 mmol/L which is practically normal for someone without diabetes but I understand that diabetics should be aiming at 4 or less.
LDL (bad) cholesterol was 3.3 mmol/L and I think this should be less than 2 for a diabetic ?
HDL (good) cholesterol was 0.89mmol/L and this should be around 1 ?

what I'd like to know is will following a LCHF diet alter cholesterol or are there particular foods which he should try and eat ?

Nurse tried to prescribe him statins (which he politely refused !) as he wants to avoid meds and manage with dietary changes if possible.
Funnily enough his overall cholesterol is actually less than it was when he was tested 10 years ago-in spite of the diabetes. I also managed to get her to print out his blood test results (very reluctantly) as our surgery doesn't allow online patient access.

Whilst there she decided to take his blood pressure which was 148/84. When he had checked at home on Friday it had been 130/94. As always for a 'normal' person a BP of 140/80 would be considered good but if diabetic you have to aim lower still....
She muttered that 'we would have to keep an eye on that' and mentioned ace-inhibitors. Hubby said that he was keen to manage it via diet and exercise and pointed out that he had been 185/112 a mere 6 weeks ago and his GP hadn't been bothered (!) I think he is doing very well but it seems the diabetic nurse doesn't believe in positive reinforcement.

So nice to get the support here

 

[Guzzler]

Many members report that on LCHF diet the cholesterol levels fall gently. The so called good fats are recommended i.e olives, avocado, oily fish etc. I think your hubby is wise to try a change in diet and excercise first before taking statins. There is a phenomina known as 'White Coat' which is that when bp is taken the bp is slightly raised it is because of a hcp doing it rather than it being done at home. Doctors are aware of this and may adjust there concern over slightly elevated readings. Hope this helps.

 

[Mep]

Where I live the goal is to keep diabetics under 5.5 for cholesterol. But obviously it's different where you live. From my experience when I did the LCHF diet previously it raised my cholesterol too high and I made the decision after being on the diet for a year and not getting good cholesterol results to stop that diet. For me the risk factor is too great because I have a family history of high cholesterol and heart disease. But I'm probably in the minority where cholesterol just stays high. I'm now on low dose of statin because my cholesterol went up again to 6.8 because of my diet changes due to other conditions. From what I read most have their cholesterol drop. You just need to at least try things and see whether or not it works first before deciding whether or not you need to change things. I wish you and your hubby the best.

 

[Bluetit1802]

As far as blood pressure is concerned, you might do well to buy a home monitor. They aren't very expensive and will enable him to check regularly in a home environment. The NHS likes diabetics to be under 140/80 the majority of the time (resting)

As for cholesterol, it is the ratios that matter. The total is just that - a total of the good and the bad, and means very little.
The ratio that experts think matters most is the Triglycerides/HDL ratio, which ideally should be under 0.87mmol/l. I see you haven't mentioned his triglycerides. Were they tested?

As @Guzzler said, there are foods that can help. The very best is oily fish, particularly salmon. Then there is avocado, nuts (walnuts, almonds and cashews in particular), olive oil and rapeseed oil, dark chocolate, and a small glass of red wine.

My personal experience is my cholesterol improved a lot once I started LCHF. Especially the HDL and triglycerides. My HDL is currently 2.47 (increased from 1.44) my triglycerides are 0.6 (were 2.01 on diagnosis). I have put this down mostly to eating a lot of salmon and very few carbs.

 

[Mep]

oh yes... forgot to mention I suffer from hypertension and here they don't like your BP over 120/80. I can go real high though with readings like 200/118, etc. I have my own BP monitor at home and use it to check if I'm ok. I'm on BP med as well... in fact on another med that can also drop BP but being used for spasms. It's important to keep the BP in check that's for sure.

 

[Sam50]

As far as blood pressure is concerned, you might do well to buy a home monitor. They aren't very expensive and will enable him to check regularly in a home environment. The NHS likes diabetics to be under 140/80 the majority of the time (resting)

As for cholesterol, it is the ratios that matter. The total is just that - a total of the good and the bad, and means very little.
The ratio that experts think matters most is the Triglycerides/HDL ratio, which ideally should be under 0.87mmol/l. I see you haven't mentioned his triglycerides. Were they tested?

As @Guzzler said, there are foods that can help. The very best is oily fish, particularly salmon. Then there is avocado, nuts (walnuts, almonds and cashews in particular), olive oil and rapeseed oil, dark chocolate, and a small glass of red wine.

My personal experience is my cholesterol improved a lot once I started LCHF. Especially the HDL and triglycerides. My HDL is currently 2.47 (increased from 1.44) my triglycerides are 0.6 (were 2.01 on diagnosis). I have put this down mostly to eating a lot of salmon and very few carbs.

Hi Bluetit1802- yes we do have a home blood pressure monitor ( a digital one) nurse was using a piece of equipment out of the ark ( you know those ones that you have a rubber/plastic pump and a large dial that looks like it's from a submarine ?) and she took 3 readings one after the other. Hubby barely had any blood left in his arm !

I think that everyone's BP becomes elevated when at a surgery, it's natural to feel a bit anxious.

Yes trigs were tested too-forgot to mention that-they are 2.3mmol/L and I think the nurse said 'normal' people should be around 1.7 and around 1 for a diabetic ?

Not sure if I got that right as I think there was a way of working out the ratio but I can't remember where I saw it.....essentially she said that it was the ratio that was of concern more than the total number. I think he needs to increase the HDL and decrease the LDL ?

He does eat fish several times a week and takes a fish oil supplement- oh he'll like the news about a small glass of red wine shall pass that nugget on thank you x

 

[Bluetit1802]

To calculate the ratio, divide his trigs by his HDL. His ratio is 2.6, so that needs attention. However, as he didn't fast for the test, his trigs were most likely higher than they should be. When we eat the trigs come out to play and swim about in our blood stream doing their job. Hence, a non-fasting test will show a high level. Next time, I suggest he fasts (water only) and no alcohol the night before. He will probably be told fasting isn't necessary, but to get an accurate trigs level. it is necessary. Just ignore them and fast anyway. I always do.

 

[carty]

By eating a low carb higher fat diet my cholesterol went from 7.9 to 5.4
CAROL

 

[noblehead]

His total cholesterol was 5.2 mmol/L which is practically normal for someone without diabetes but I understand that diabetics should be aiming at 4 or less.

Here are the guidelines:

• Your total cholesterol level should be below 4.0mmol/l.
• LDL levels should be less than 2.0mmol/l.
• HDL levels should be 1.0mmol/l or above in men and 1.2mmol/l or above in women.
• Triglyceride levels should be 1.7mmol/l or less.

https://www.diabetes.org.uk/Guide-to-diabetes/Managing-your-diabetes/Testing/

Whilst there she decided to take his blood pressure which was 148/84. When he had checked at home on Friday it had been 130/94. As always for a 'normal' person a BP of 140/80 would be considered good but if diabetic you have to aim lower still....

The bottom figure (diastolic) on friday and in the clinic is above what it should be for someone with diabetes, have a read of the following which has some great information and advice on bp and the importance of keeping it on the lower-side:

http://www.diabeticretinopathy.org.uk/prevention/Diabetes and Blood Pressure.htm

 

[Bluebirdsinging]

As far as blood pressure is concerned, you might do well to buy a home monitor. They aren't very expensive and will enable him to check regularly in a home environment. The NHS likes diabetics to be under 140/80 the majority of the time (resting)

As for cholesterol, it is the ratios that matter. The total is just that - a total of the good and the bad, and means very little.
The ratio that experts think matters most is the Triglycerides/HDL ratio, which ideally should be under 0.87mmol/l. I see you haven't mentioned his triglycerides. Were they tested?

As @Guzzler said, there are foods that can help. The very best is oily fish, particularly salmon. Then there is avocado, nuts (walnuts, almonds and cashews in particular), olive oil and rapeseed oil, dark chocolate, and a small glass of red wine.

My personal experience is my cholesterol improved a lot once I started LCHF. Especially the HDL and triglycerides. My HDL is currently 2.47 (increased from 1.44) my triglycerides are 0.6 (were 2.01 on diagnosis). I have put this down mostly to eating a lot of salmon and very few carbs.

As far as blood pressure is concerned, you might do well to buy a home monitor. They aren't very expensive and will enable him to check regularly in a home environment. The NHS likes diabetics to be under 140/80 the majority of the time (resting)

As for cholesterol, it is the ratios that matter. The total is just that - a total of the good and the bad, and means very little.
The ratio that experts think matters most is the Triglycerides/HDL ratio, which ideally should be under 0.87mmol/l. I see you haven't mentioned his triglycerides. Were they tested?

As @Guzzler said, there are foods that can help. The very best is oily fish, particularly salmon. Then there is avocado, nuts (walnuts, almonds and cashews in particular), olive oil and rapeseed oil, dark chocolate, and a small glass of red wine.

My personal experience is my cholesterol improved a lot once I started LCHF. Especially the HDL and triglycerides. My HDL is currently 2.47 (increased from 1.44) my triglycerides are 0.6 (were 2.01 on diagnosis). I have put this down mostly to eating a lot of salmon and very few carbs.

Hi, just wondering if it's safe for me to be doing the low carb diet,
These are my current blood teat results July 23
Serum cholesterol 6.2
Triglyceride 1.6
Seen chlesterol/HDL ratio-6
HD 1.03
LDL4.4

 

[serenity648]

Hi, just wondering if it's safe for me to be doing the low carb diet,
These are my current blood teat results July 23
Serum cholesterol 6.2
Triglyceride 1.6
Seen chlesterol/HDL ratio-6
HD 1.03
LDL4.4

I do the low carbing bit, with cautious use of fats. That might work for you too.

 

[Bluetit1802]

Hi, just wondering if it's safe for me to be doing the low carb diet,
These are my current blood teat results July 23
Serum cholesterol 6.2
Triglyceride 1.6
Seen chlesterol/HDL ratio-6
HD 1.03
LDL4.4

Why wouldn't it be safe?
Carbohydrate is known to reduce HDL, so that is a good place to start - low carb. Your HDL is on the low side so needs a boost.
Your trigs are fine
Your LDL is high but can be reduced by eating lots of oily fish (salmon especially), almonds, walnuts, cashews, olive oil, rapeseed oil, dark chocolate, avocado, a small glass of red wine.
Exercise also helps a lot.

 

[lindisfel]

Here are the guidelines:

• Your total cholesterol level should be below 4.0mmol/l.
• LDL levels should be less than 2.0mmol/l.
• HDL levels should be 1.0mmol/l or above in men and 1.2mmol/l or above in women.
• Triglyceride levels should be 1.7mmol/l or less.

https://www.diabetes.org.uk/Guide-to-diabetes/Managing-your-diabetes/Testing/




The bottom figure (diastolic) on friday and in the clinic is above what it should be for someone with diabetes, have a read of the following which has some great information and advice on bp and the importance of keeping it on the lower-side:

http://www.diabeticretinopathy.org.uk/prevention/Diabetes and Blood Pressure.htm

Then they are not up to date, and according to Framingham study they are at risk from CVD! See the 3D graph on Fat Emporer. If the HDL gets up to nearer 2.0, the trigs usually drop and one has very little damaging LDL, in fact the LDL is pretty much irrelevant.
The brain works on fat, I reckon if I dropped my cholestrol to those levels I would have brain fog.

 

[Sam50]

thanks- when he goes back to have the repeat blood tests I'll make sure that he doesn't eat breakfast beforehand. I did think it seemed a little strange not to do a fasting one. Best to get everything on your side that you can

 

[Bluebirdsinging]

Why wouldn't it be safe?
Carbohydrate is known to reduce HDL, so that is a good place to start - low carb. Your HDL is on the low side so needs a boost.
Your trigs are fine
Your LDL is high but can be reduced by eating lots of oily fish (salmon especially), almonds, walnuts, cashews, olive oil, rapeseed oil, dark chocolate, avocado, a small glass of red wine.
Exercise also helps a lot.

Thanks that's good to know. My nurse at the centre does not know much.....my bloods have come down in the last two days 6-8.5 yesterday and 6.5-8.5 today, so that is good news lots of avocado, salmon dark chocolate and humous...

 

[Daibell]

Hi. A few points. There is no reason for any diabetic who has well-controlled blood sugar to be treated any differently from a normal person with regard to cholesterol or BP; it's not based on any good science. The whole cholesterol things is very questionable and as my diabetes GP said a few years back when NICE changed the target from 5 to 4 total that soon we will no fat left in the body. The whole BP things is also questionable. My BP in the surgery is over 140/80 but when I test at home it's nearer 125/75. MY DN now takes my home readings, averages them and puts them on my record and ignore the surgery reading. Also, this 140/80 thing is very questionable if you are older. If you Google the web you will find no research for people over 65 yet if you extrapolate the rising BP as you age it means around 150/80'ish is fine when in the 70s as I am. The medics just take figures out of context and preach the same numbers to everyone. As usual it pays to do your own research.

 

[noblehead]

Then they are not up to date, and according to Framingham study they are at risk from CVD! See the 3D graph on Fat Emporer. If the HDL gets up to nearer 2.0, the trigs usually drop and one has very little damaging LDL, in fact the LDL is pretty much irrelevant.
The brain works on fat, I reckon if I dropped my cholestrol to those levels I would have brain fog.

Check the Notes in the article, it does say that the figures should be maintained as a guide:

However, Diabetes UK Council of Healthcare Professionals (CHP) has advised that the general targets used previously should be maintained as a guide, and healthcare professionals should be encouraged to use their clinical judgement in discussing individual targets. Made up of healthcare professionals across the board, the Council of Healthcare Professionals (CHP) is an advisory body, whose members inform the work of Diabetes UK.

 

[Bluetit1802]

Check the Notes in the article, it does say that the figures should be maintained as a guide:

The problem there is that doctors take those figures as actual targets to be met and maintained, not as a guide. Total over 4 and statins get pushed on you, even if a large part of that total happens to be good cholesterol.

NICE pathway says that among other things, doctors should perform the Q-Risk formula to assess CVD risk. This formula only asks for the Total/HDL ratio. Nothing else about cholesterol. It used to ask for LDL and triglycerides, but no longer.

 

[bulkbiker]

The problem there is that doctors take those figures as actual targets to be met and maintained, not as a guide. Total over 4 and statins get pushed on you, even if a large part of that total happens to be good cholesterol.

NICE pathway says that among other things, doctors should perform the Q-Risk formula to assess CVD risk. This formula only asks for the Total/HDL ratio. Nothing else about cholesterol. It used to ask for LDL and triglycerides, but no longer.

Also once you have been diagnosed Type 2 you will always "fail" the Q-Risk score as being diagnosed adds I think 7-8% onto your score even if your HbA1c is below Type 2 levels (there is nowhere to put your HbA1c).

Made up of healthcare professionals across the board, the Council of Healthcare Professionals (CHP) is an advisory body, whose members inform the work of Diabetes UK.

And probably know very little about the mechanisms of cholesterol...

 

[noblehead]

The problem there is that doctors take those figures as actual targets to be met and maintained, not as a guide. Total over 4 and statins get pushed on you, even if a large part of that total happens to be good cholesterol.

Not all Dr's do @Bluetit1802

After a health scare some years ago (at first it was thought it was CVD related but turned out it wasn't) I was given a prescription for a statin due to my age and longevity with type 1, when chatting to my regular gp he dismissed the suggestion that I should take statins as I had excellent cholesterol levels (TC was 4.3 at the time), I exercised regularly and ate a healthy diet, he said we could look at things again in 5 years time, it's roundabout that time now but statin's have not been mentioned since.